title: Clinical features of patients with stress-induced cardiomyopathy associated with renal dysfunction: 7 case series in single center.
abstract: BACKGROUND
  Stress-induced cardiomyopathy (sCMP) is characterized by transient wall-motion abnormalities involving the left ventricular apex and mid-ventricle that are precipitated by emotional or physical stress. As the heart and kidney influence each other's function through bidirectional pathways, sCMP can induce renal dysfunction or be induced by renal dysfunction. This study reviewed the clinical characteristics and outcomes of patients with confirmed sCMP associated with renal dysfunction.
  
  
  METHODS
  We conducted a retrospective analysis of the medical records of all patients from our institution who were diagnosed with sCMP from March 2010 to April 2012. Each patient's demographic characteristics, presenting symptoms, triggering events, electrocardiographic characteristics, laboratory data, echocardiographic study findings, cardiac catheterization data, and outcomes were reviewed.
  
  
  RESULTS
  Among 30 patients who were diagnosed with sCMP, 7 patients had associated renal dysfunction. Three patients were on maintenance hemodialysis (HD) and 4 patients had acute kidney injury (AKI). Their mean ejection fraction was 35.2% at initial echocardiography, and 57.2% at follow-up echocardiography. Pericardial effusion was detected in all HD patients initially; these patients were treated with intensive HD for suspected under-dialysis status. In patients with AKI, the mean peak serum creatinine was 4.17 mg/dL. Two patients were treated with continuous renal replacement therapy. One patient required maintenance HD, and 1 patient died. Two patients had full renal recovery to their baseline renal function at 7 and 14 days.
  
  
  CONCLUSIONS
  Patients with renal dysfunction including those with AKI and those undergoing HD can develop sCMP, renal function must be closely monitored in patients with sCMP. Additionally, it should be considered that patients on HD who develop sCMP may be under-dialyzed.
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Pusan National University School of Medicine, Gudeok-ro 179 Seo-gu, Busan, Republic of Korea. sey-0220@hanmail.net.
authors.forename: Min Ji
authors.initials: MJ
authors.lastname: Shin
authors.forename: Harin
authors.initials: H
authors.lastname: Rhee
authors.forename: Il Young
authors.initials: IY
authors.lastname: Kim
authors.forename: Byeong Yun
authors.initials: BY
authors.lastname: Yang
authors.forename: Sang Heon
authors.initials: SH
authors.lastname: Song
authors.forename: Dong Won
authors.initials: DW
authors.lastname: Lee
authors.forename: Soo Bong
authors.initials: SB
authors.lastname: Lee
authors.forename: Ihm Soo
authors.initials: IS
authors.lastname: Kwak
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Choi
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Seong
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology* / Q000534:rehabilitation*; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D054549:Takotsubo Cardiomyopathy / Q000150:complications* / Q000175:diagnosis*